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Martin Regg Cohn: Pharmacare the first casualty of Doug Ford’s hasty hidden agenda

Martin Regg Cohn: Pharmacare the first casualty of Doug Ford’s hasty hidden agenda
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On his first day in power, Doug Ford boldly declared himself — in writing — premier of “Ontario’s First Ever Government for the People.”

On the second day, his government’s next declaration came ever so quietly, lest “the people” notice. In the middle of the Canada Day long weekend, a brief news release from Health Minister Christine Elliott made this surprise announcement:

OHIP+ is on its deathbed. No longer will all young people aged 24 and under get free prescription medications at their local pharmacies through the province’s first-ever pharmacare program.

Elliott’s statement, issued shortly after noon on Saturday, claims the Progressive Conservatives will “fix the OHIP+ program” to make it more “cost-effective.” You could call this resuscitation by amputation and decapitation.

In future, young people will have to turn first to their parents’ workplace plan — if they have one — that covers some or all of their expenses. Only if they have no coverage, or face additional costs, will they be able to turn to the government as a last resort, months later, for reimbursement that remains indeterminate.

On the campaign trail, Ford spoke often about his plans to cut billions in government waste because “the party with taxpayers’ dollars was over.” But he vowed to protect health-care spending, and young people had every reason to believe that a program supplying essential prescription medicines would survive Ford’s axe.

In fact, all major parties supported pharmacare in principle when it was first introduced last year. But OHIP+ is now part of the premier’s “shock and awe” campaign to show that the Tories know how to save money.

Even while wasting more of it. For these are false economies based on phony premises.

You don’t have to love pharmacare, medicare, socialized medicine, or socialism to appreciate the benefits of universal health care with comprehensive coverage. It’s not necessarily a matter of empathy or ideology, but efficiency — something Tories can surely support as much as Liberals or New Democrats.

By analogy, business think tanks have come to embrace pharmacare as a cost-effective way to benefit from a single-payer system that eliminates the waste of private insurance companies duplicating overhead and services (both administrative and diagnostic), while ramping up the scale of government purchasing power to save money on bulk buying, and also selecting the most cost-effective drugs (notably generics) to treat patients. Oh, and pharmacare doesn’t force people with strep throat to first cough up the money at a pharmacy, or check their parents’ benefits plan and wait for (possibly partial) reimbursement, and then hope the government will backstop them later.

We would never take such a step backwards for medicare, so why do it for pharmacare? You don’t pay a doctor out of your own pocket, and then hope your parents’ plan will cover the costs, and only then turn to the government.

Yet that American model of pay-and-paperwork-as-you-go medicine is precisely what Ford’s Tories want to bring back to Ontario for prescription drugs, mere months after the province took the first steps toward the universal a half-century ago with the dawn of medicare.

It’s no surprise that the governing Tories have a hit list of programs to be axed, starting with the cap-and-trade program that was Ontario’s best bet for fighting global warming. As Ford reminded us this week, “I promised that the party with taxpayers’ dollars was over and that this would include scrapping the cap-and-trade carbon tax slush fund.”

That’s his right, right or wrong. But who knew that the principle of universality under pharmacare fell into the category of holding an improper “party with taxpayers’ dollars?”

As for Ford’s allegation that cap and trade amounts to a “slush fund” — some slush. A typical example of how the money was spent: $1 million went to Barrie’s Royal Victoria Hospital to reduce costs in patient rooms, saving money for health care.

In fairness to Ford, he never hid his antipathy to this environmental program. But if cap and trade topped his public campaign agenda, slashing pharmacare so sneakily over a holiday weekend falls squarely into the hidden-agenda department

OHIP+ wasn’t perfect, but it laid the groundwork for a long overdue national pharmacare program. The PC government’s ideological preference for private insurers cries out for greater consultations and preparations beyond a press release cobbled together on Day 2, out of the Tory blue.

In his haste to demonstrate decisiveness, Ford’s first 100 Days of Action are turning into 100 Hours of Distraction and Destruction. For the people.
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